T Wa00 lives in Germany. He was 58 when he was diagnosed in November, 2004. His initial PSA was 10.40 ng/ml, his Gleason Score was 6, and he was staged T1b. His choice of treatment was Brachytherapy (Seed Implant). Here is his story.

In 1998 I was still living in the UK, my local GP carried out a DRE (Digital Rectal Examination) and expressed some concern at the size of the prostate. I had not experienced any problems with emptying my bladder and rarely got up overnight and did not have any other indications of a problem.

I was sent to the consultant who took my first PSA test back in November 1998 (4.10 ng/ml) and then proposed a biopsy. The biopsy showed no signs and I went on watchful waiting with a 6 monthly PSA check. Over the next 4 years it fluctuated around 4.4o ng/ml to 5.8o ng/ml - sometimes down; sometimes up. I had one further biopsy that indicated some precursor cells but no cancerous cells were found.

In May 2003 it had risen to 6.70 ng/ml, but my local GP said I should not panic until it went in to double figures! So I relaxed and moved to Germany in August 2004.

In September 2003, I had experienced a mild heart attack and subsequently in December 2003 had undergone a mini CAB (keyhole surgery in the breast area to bypass a blocked artery) and two angioplasty operations to clear two arteries.

As a routine follow up I visited a heart doctor in Munich to check that everything was OK, and being German they ran every test under the sun. She was very happy with the heart results, but was very unhappy with my PSA (7.20 ng/ml) and sent me to a local Urologist.

I was shocked when he carried out a DRE and said he was 99% sure I had a cancer in the left lobe and needed a biopsy to check on both lobes. The biopsy indicated up to 12 small tumours around 1 cm in size (T1b N0 G2 M02, Gleason 6 (3a+3b))

I subsequently had X-rays, MRI and CT scans which indicated that the cancer was contained inside the prostate.

We talked about the methods and basically pushed for either surgery or brachytherapy (ultrasound and other techniques were not an option), but said it had to be my decision and gave me a list of surgeons to talk with and discuss. However, based on which choice he was quite explicit as to who should carry out the operations!!

I was not comfortable with surgery again as it had taken 6 months for my body to recover from the heart operations, but I tried to be as unbiased as possible. Eventually I decided on the Brachytherapy as the initial problems seemed to be less.

January and February 2005, were then taken up with visits to the Surgeon, pre-planning and check up with my heart doctor, anesthetist and radiologist to ensure that I was capable of the operation, that I understood all the potential problems and had signed all the papers required in Germany to enable the operation to go ahead. Plus I was given a piece of paper for customs to say I was not a potential radio active risk when travelling abroad by plane.

I decided on an in-patient treatment and went in on the 5th March 2005. The operation took place on March 6th and was remarkably painless apart from problems inserting a tube into my left arm. They inserted 43 seeds using the radioactive Iodine seeds on strands.

The first 6 weeks have been very good and had managed to get back to my normal running routine.

However, this week I hit a road block, and have experienced immense tiredness and feelings of sickness - not sure what is causing this problem.

I am on Omnic (tamsulosin - flomax)for increasing the urine flow by reducing an inflammation and Proscar (finasteride) which reduces the prostate size. I am told I will be on them for at least 6 months, probably 12 months.

I also continue my heart tablets (an ACE and an anti chloresterol drug).

UPDATED

August 2006

I guess that in general I still find the whole thing, a case of 2 steps forward, and every time it looks good 1 or 2 steps backward!

I think in general since April 2005 I have had a very easy time, with initial burning effects when passing water, and a slow stream. I would go 2 or 3 times a night. Also sex was OK although about the 6 month period I did take Viagra occasionally.

At 9 months, life was very positive, no urgency, steady streams when passing water during the day, and probably 0 or 1 calls in the night, when it would be more difficult. No sexual problems.

Now, since the 13 months point I have experienced some problems. I use Viagra more (although I think it's more a mental problem, especially at night!), I have had a 3 month period when I had a real burning issue when passing water (it has just disappeared as suddenly as it started), and I am getting up 1 to 3 times during the night when it takes a while to empty the bladder. So something is happening down below, but what is hard to define.

During this time my PSA has stayed at about 2.5 which is kind of tricky, I keep waiting for it to drop (or worse go back up). Overall, I believe that apart from this PSA factor, I have had a very easy time with problems that are pretty mild.

UPDATED

September 2006

In my last update, I mentioned the problems in passing water and the burning sensations that had also started again – well dramatically they have now disappeared and I am back to normal. With Brachytherapy you truly take each day at a time – problems suddenly appear and can disappear just as fast.

UPDATED

November 2007

I am now nearly into my 3rd year since the operation and in general my health has been good, with currently no problems. I still take Viagra, although when surprised by my wife we manage to accomplish the task in hand usually quite well!

My PSA since the last test is at the lowest it has been for some time, so the next one will be really interesting, the PSA figures are as follows:

So you could say this has been a long "bounce" – although further checks (scans etc) show no incidence of the cancer. So as I have said before I take each day as it comes and wait to see what the future holds!

UPDATED

September 2008

Since my operation in March 2005 my PSA has between Jan 2006 and June 2007 oscillated between 2.43 and 3.22 (high in 11/2006) which caused some concern. Since October 2007 it has progressively dropped and is now down to .588.

I guess it illustrates some of the extremes of a "bounce". During this period I had some extensive scans which showed no problems.

At the moment I am back to where I started with all facilities and no problems that I am aware of - life is pretty good and medically I appear to be better than I was 10 years ago - although older and with that the problems that age brings - I do not recover as quickly as I once could!

Regards Tony

UPDATED

January 2010

As of January 1, 2010 have no issues with PCa treatment, medical health is good and no problems either with ED or ability to urinate.

I guess in summary that I am as healthy as I can be at my age, with 9km runs 3 times a week, as well as regular walks with my labrador dog which also keeps me pretty fit.

UPDATED

March 2011

My current position is the same as Jan 2010, with PSA for the last few years hovering around 0.22.

Last medical check was in January 2011, where I was pronounced as being very healthy, with my organs in extremely good shape (heart, lungs, liver etc). I usually run about 10 kilometres three times a week, and as before my Labrador makes sure I am up early enough to handle his three to four walks a day.

Apart from the issue of waiting for the results from the next check-up (always a concern!), everything touch wood is very good.

My eldest brother has recently been notified that he has PCa and is going with radiation treatment, so it brings back memories – however, like many guys he was extremely reluctant to ask questions, and largely just went with what the specialist told him – so much for our great experience and pooled resources!

Best regards Tony

UPDATED

March 2012

So another year and an all time low for my PSA, so must be on a roll.

My general health on the PCa side has been good, with no known problems either from continence or sexual. In fact I should be in stunning health apart from the fact that I had a slipped disc operation in December 2011 which went well, but unfortunately the drugs used to put me under also took out the liver, so spent January 2012 with chronic hepatitis (a lovely shade of deep yellow) and the following months recovering. So as at March 31, 2012 ALMOST back to normal blood counts but still cannot drink alcohol.

So a great PSA reading in March (0.06) accompanied by a zero blood alcohol figure (not so good!)

UPDATED

May 2013

Will have PSA test end of May... will update then.

UPDATED

June 2013

So into 2013 and still recovering from my slipped disc/liver issues, but the prostate doesn't seem to be a problem.

Just had a check up and apart from changing my statin medication again due to liver /muscle pain issues, the prostate looks good with a new low figure.

PSA continues to drop from last reading, although cannot see it going much lower!

Everything is stable and I can honestly say that I don't think much about the issue apart from remembering to have a test each year. I have no issues that I am aware of relating to PCa, only those relating to my ageing body (currently meniscus op in left knee!).

Continue to see badly informed Doctors not fully discussing issues with patients or testing them to late e.g. Neighbour tested at 70 after having problems passing water - cancer spread alread to bones.

My father-in-law was advised to have surgery, and when his wife was prodded to ask the Doctor about other treatments, teh Doctor then discussed all the available treatments and issues.He ended up with Brachytherapy and has been fine so far.

So now I am now 9 years out and with continuing positive outcomes.

UPDATED

November 2015

Over 10 years out! .... still in good health apart from slowly improving left knee 18 months after operation --- consultants!! Improvement thanks to my wonderful physio lady.

Latest blood tests probably best for a long time ... even cholesterol levels all time good!

So all I can say is for me Brachytherapy was best decision possible with only good outcomes (great American terminology!)

UPDATED

December 2016

Now 11-1/2 years since the Brachytherapy operation and it has become a distant memory - it's true you only remember the good things!

PSA is now at its lowest < 0.01 and issues around PCa and the subsequent operation are non existant.

There are often stories that after 10 years people that take the radiation path will have issues, well all that I can say is that I have not experienced such issues - I have no continence issues and my erectile function is the strongest that it has been for many years and is good.

Overall, I am in excellent health although I experience more issues from failing joints! Age!